DATE: September 10, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Felony Incompetent to Stand Trial Infrastructure Grant Program Application
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Director of the Department of Behavioral Health to submit a grant application to the California Department of State Hospitals for the Felony Incompetent to Stand Trial Infrastructure Grant Program Application for up to $13,125,000 for diversion and/or community-based restoration programs; and
2. Approve and authorize the Director of the Department of Behavioral Health to submit a letter of intent informing the California Department of State Hospitals of the County’s intent to contract with them for the purpose of serving Felony Incompetent to Stand Trial defendants through a Felony Mental Health Diversion Community-Based Restoration program.
REPORT
The California Department of State Hospitals (DSH) has issued a Request for Proposal (RFP) for the Incompetent to Stand Trial Infrastructure Grant Program, to build out the state’s capacity of residential treatment homes and facilities. This funding opportunity is open to California counties that commit to contract with DSH for ongoing diversion and/or community-based restoration (CBR) programs. The County is eligible to apply for up to $13,125,000.
There is no additional Net County Cost associated with the approval of the recommended actions. The Department of Behavioral Health (Department) will collaborate with its community partners including the Fresno County Superior Court, Fresno County District Attorney’s Office, Fresno County Public Defender’s Office, the County Administrative Office as well as community-based organizations in the development of diversion and CBR residential treatment homes and facilities. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board does not approve the recommended actions, the County would forego up to $13,125,000 in State funding to construct new facilities or renovate facilities to house Felony Incompetent to Stand Trial (FIST) persons served. Additionally, the Department would have to return to your Board for signature on all necessary grant funding documents, reports and forms.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. If awarded grant infrastructure funding, the County will be eligible to build or renovate up to 140 FIST beds. DSH will reimburse the County at the rate of $93,750 per bed, with maximum funding of $13,125,000. No County matching contribution is required. The grant allows recipients to use up to 15% of total grant funds for administrative costs. County will receive infrastructure funds upon approval of the project application packet which will be created by the Department and submitted to DSH after receipt of the grant award letter. At that time the Department will seek approval from your Board for a Budget Resolution which will include the total funds awarded by DSH based upon the number of beds involved in the building project.
DISCUSSION:
On March 1, 2023, DSH released Round 1 of the FIST Diversion and Community Based Restoration Infrastructure Program RFP. On June 20, 2024, the RFP was revised with the deadline to submit responses extended to October 31, 2024. Funding is available to build out the state’s capacity of residential treatment homes and facilities. This funding opportunity is open to California counties that commit to contract with DSH for ongoing diversion and/or CBR programs. All infrastructure funds must be expended by June 30, 2028. The County is eligible to apply for a maximum amount of $13,125,000.
On September 22, 2020, the County entered into an agreement with DSH for a pilot diversion program for FIST persons served which funds specialty mental health and supportive services. This DSH agreement allowed for a continuum of care to be developed for flexibility in moving the person served between the different levels of care seamlessly as clinically indicated to meet their unique specialty mental health, substance use disorder, and/or any additional wraparound service needs. The levels of care included Assertive Community Treatment, Full Service Partnership, Intensive Case Management, Outpatient, and Outreach and Engagement. If awarded the Infrastructure Grant, the County will be required to commit to using the property(s) to serve DSH identified clients for 30 years for new construction projects or 20 years for rehabilitation/renovation projects.
The ongoing cost of supportive services will be provided through a separate service agreement with DSH. Counties will receive $125,000 per felony FIST persons served apportioned over 18 months, treated in either a CBR or a diversion program. This rate is intended to support an intensive community treatment model with increased frequency of clinical contacts and access to psychiatry services, as well as all wraparound services. Admission into a diversion and/or CBR program is administered by the courts, and individuals charged with certain types of felonies are excluded. If defendants are successful in the program, their current charges may be dropped, or their competency restored so that criminal proceedings can resume.
The services to be provided through this grant program will be part of a collaborative effort between the Fresno County Superior Court, District Attorney’s Office, Public Defender’s Office, community-based organizations, and the Department.
If awarded, the Department will return to your Board for approval of the proposed grant agreement and any community-based housing and treatment facility agreements.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of this agenda item at the August 15, 2024 meeting.
REFERENCE MATERIAL:
BAI # 26.1, September 22, 2020
BAI # 32.1, October 23, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Grant Proposal Documents
On file with Clerk - Letter of Intent
On file with Clerk - Letter of Support DBH
CAO ANALYST:
Dylan McCully